CROSS-CULTURAL ADAPTATION UKRAINIAN LANGUAGE VERSION TORONTO ALEXITHYMIA SCALE TAS-20: APPROBATION IN PATIENTS WITH ANKYLOSING SPONDYLITIS

Vasylets V.V., Shapoval I.I., Shalkovskyi E.I., Klebanska A.O., Stanislavchuk M.A.

• National Pirogov Memorial Medical University, Vinnytsya

Summary. Alexithymia (AL) is considered a stable personality trait, which, together with other factors of the external environment, contributes to the exacerbation of somatic diseases and can be a factor in the occurrence of mental disorders. Furthermore, it has been proven that AL is associated with chronic pain and significantly affects role-based physical and social functioning. Ankylosing spondylitis (AS) is a chronic, multisystemic inflammatory disorder characterized by long-lasting and pronounced pain syndrome, which is a predictor of the development of AL; therefore, there is an urgent need to screen these patients for the detection of AL. The aim of the study: the creation of the Ukrainian-language version of the Toronto alexithymia scale TAS-20 and its cross-cultural adaptation with the assessment of validity and approbation in patients with AS. Methods and materials: 65 patients with AS, according to the modified New York criteria, and 55 practically healthy individuals without signs of AS were included in the study as a control group. We used the latest revised version of the Toronto Alexithymia Scale (TAS-20) for validation. The research was carried out in compliance with basic bioethical norms. All patients consented to participate in the study, after which a full clinical examination was performed: demographic data were collected, disease-specific indicators (BASDAI, BASFI, BASMI, ASQoL, ASAS HI/EF) were assessed, and alexithymia screening was performed according to TAS-20. Statistical analysis was performed using the IBM SPSS23 program. Results: The data analysis proved the high reliability and validity of the Ukrainian-language version of the Toronto alexithymia scale TAS-20 for screening patients with AL. Cronbach’s α coefficient calculations based on the test and retest results (after 14 days) confirmed the internal consistency of the TAS-20 (0.7 and 0.7, respectively). The intraclass correlation coefficient was determined, which was 0.996 (р<0.05). In addition, Student’s paired t-test did not reveal significant differences between the test-retest groups (p >0.05). In the subsequent study on approbation of the TAS-20 scale, patients with AS were conducted. Patients with AS were characterized by high activity and significant loss of functional capacity. The moderate impact of the disease on the quality of life and health of patients was also revealed. The results of the TAS-20 survey showed statistically significantly higher values of the TAS-20 overall score in patients with AS (49.58±10.57) compared to practically healthy individuals of the control group (39.89±8.73), p < 0.0001, which indicates a high level of AL in patients with AS. Conclusions: The Ukrainian-language version of the Toronto Alexithymia Scale TAS-20 was created, and its cross-cultural adaptation was carried out for further use in the Ukrainian-speaking population. The Ukrainian version of the TAS-20 scale has sufficient reliability, allowing it to be used for scientific purposes and in clinical practice. AL in patients with AS is found in almost every fifth patient, and another 26% of patients have borderline values of the AL scale, while in the group of healthy people, the corresponding levels of TAS-20 are recorded from 1 to 5% of the examined. The clinical significance of AL in AS patients needs further research.